Before and After School Care Information 2020-21

Please fill out for all children attending Explorers. Explorers BAS is currently FULL. PLease fill out the form and you will be nodified if a spot becomes free.

1st Child's Name:*

First NameLast Name

Gender:*

MaleFemale

Date of Birth:*

Date

Type a question*

Before & After School Care - $235/monthBefore School Care - $130/monthAfter School Care - $180/monthKindergarten Care - $135/month (Before & After on KG days)Prepaid Casual Care - $150 for 10 SessionsPrepaid Casual Care - $300 for 20 Sessions

2nd Child's Name:

Gender:

MaleFemale

Date of Birth:

Date

Type a question

Before & After School Care - $235/monthBefore School Care - $130/monthAfter School Care - $180/monthKindergarten Care - $135/month (Before & After on KG days)Prepaid Casual Care - $150 for 10 SessionsPrepaid Casual Care - $300 for 20 Sessions

Please add addition children here:

Mother's Name:

Mother's Email:

Mother's Cell Phone:

Area CodePhone Number

Mother's Home Phone:

Area CodePhone Number

Mother's Business Phone:

Area CodePhone Number

Father's Name:

Father's Email:

Father's Cell Phone:

Father's Home Phone:

Father's Business Phone:

Please state any shared custody, if applicable:

(Divorced/separated with shared bi-weekly custody)

Child's primary Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are you new to Canada?*

NoYes

If yes, where are you from:

How long have you been in Canada?

Number of Years

First Language spoken at home:

Second Language spoken at home:

Do your children have health issues? If so please describe:

Do your children have allergies? If so list here.

Do your children have any physical, social, or emotional challenges we should be aware of? If so describe here:

Two other people to contact in case of emergency if parents cannot be contacted:

First Emergency Contact's Name*

First NameLast Name

Release for Pick ups*

Yes this person can pick upNo this person cannot pick up

Relationship to Child:*

Cell Phone:*

Area CodePhone Number

Home Phone:

Area CodePhone Number

Second Emergency Contact's Name*

First NameLast Name

Release for Pick ups*

Yes this person can pick upNo this person cannot pick up

Relationship to Child:*

Cell Phone:*

Area CodePhone Number

Home Phone:

Area CodePhone Number

Please list the names of the people into whose custody we may dismiss your child(ren). Your children will not be allowed to leave the school with anyone not listed below. You can add people to this list at any time.

Name

First NameLast Name

Relationship to Child:

Phone Number

Area CodePhone Number

Name

First NameLast Name

Relationship to Child:

Phone Number

Area CodePhone Number

Please list others that can pick up here:

Is your child also attending Tykes N Tots Daycare at Cardinal Leger School?

YesNo

Please provide any further information relating to your child that would be helpful in understanding and caring for your child:

Payments are DUE Sept 5th, 2020
Payment options will be outline in the Explorer confirmation Email once all school year is decided.

Cheque payments are made out to Explorers
Fees are pre-paid monthly with 10 postdated cheques for the 1st or 15th of every of every month or one for prepaid casual care.

or 10 etransfers set up monthly.

For the first and second child of the same family the above rates apply, for third/fourth child the rate is 25% disscount.

AGREEMENT: One month written notice to withdraw or change your registration status of your child is required. Notice must be given on the first of the month. I understand that a full social resume must be completed before my enrolment is complete. I hereby acknowledge that I am aware of the conditions stated in this agreement and agree to abide by these requirements.

COVID-19 Warning & Disclaimer : COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. recommend social distancing as a mean to prevent the spread of the virus. COVID-19 can lead to severe llness, personal injury, permanent disability, and death. Participating in programs or accessing Explorers facilities could increase the risk of contracting COVID-19. Explorers in no way warrants that COVID-19 infection will not occur through participation in our programs

Signature

Before & After School Care Information

Parent/Guardian Contact Information:

Release for Pick ups